Coronavirus in the US

Parent Cafe
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best wishes Romani!
I’m sure I speak for of all us on CC.

For everyone else- the next 8 weeks are going to be really ugly. Stay safe, wear masks AND gloves when you venture out from your homes, and above all- Keep Calm.

This WILL pass. A vaccine WILL be made, and millions WILL become immune to Covid- 19, either with the vaccine or exposure to the virus.

But this pandemic WILL change the world and all who survive it.

It’s time to start thinking about how to prevent this from happening again, in our lifetimes, or the lifetimes of our children or their children.

Its time to listen to and trust the world’s scientists, and get politicians the hell out of their way.

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If you’re living with your SO and you’ve both been quarantined for 2 weeks, what is the risk? (Both, admittedly, are not givens but applies to most couples giving birth right now.) And if you ARE worried, they should wear masks the whole time but still allowed to be there.

The medical team is more likely to have the infection than your partner.

There is a big difference between not letting a partner be there when you give birth and not allowing people to be there when you’re dying or have died of an infectious disease.

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…“The president wanted everyone to know where this virus is so that people would be aware if they were gonna travel to that area, that that area had a very significant amount of COVID-19 or the coronavirus,” Birx said. “And so it’s really to make Americans aware about traveling to New York, but also make it clear to the people who are in that area to protect them selves following the guidelines, to really stay home and really hunker down, stay at home and really follow the washing of your hands and not touching your face.”

Birx told Fox News anchor Jackie Ibanez, who filled in for Judge Jeanine Pirro amid technical difficulties, that Americans still need to continue following the guidelines.

“Even if you don’t think … there’s a virus there, it probably is,” Birx said. “We don’t think any city will be spared from this virus.”

https://www.extremetech.com/extreme/308236-mit-develops-cheap-open-source-ventilator-for-coronavirus-treatment
"MIT Develops Cheap, Open Source Ventilator for Coronavirus Treatment
By Ryan Whitwam on March 26, 2020
Flipboard

As the coronavirus pandemic continues to worsen, medical centers around the world have started running short of vital supplies like masks, gloves, and disinfectants. Hospitals are also running critically low on ventilators, which can keep COVID-19 patients alive if the disease becomes severe. An MIT team has developed an open-source ventilator called the MIT E-Vent that could get regulatory approval soon.

The E-Vent is based on a project that started almost a decade ago as part of the MIT Precision Machine Design course. Unlike the expensive mechanical ventilators at hospitals, this is a manual ventilator that personnel would need to operate by hand. Students designed the device for use in rural areas and developing nations where mechanical ventilators were not available or reliable. The team built a prototype (above) and published a paper, but the project didn’t move beyond that.

With ventilators in such short supply, the abandoned project has been revived and submitted to the Food and Drug Administration (FDA) under an “Emergency Use Authorization.” The FDA is conducting tests with pigs and could approve the design in the near future.

When MIT students did the initial work a decade ago, they estimated the device would cost about $100 to build. That’s considerably lower than the price tag on mechanical ventilators that are in such short supply. The current team didn’t just revive the existing design and call it a day, though. They made modifications to ensure the device would be easy to make and operate, and they developed a new metal frame for improved durability.

Coronavirus particles (orange) emerging from a cell in culture.
Only the most severe COVID-19 infections require a ventilator, which delivers oxygen at higher pressures to keep patients breathing. The US currently has about 170,000 ventilators in hospitals, but many experts warn that severe coronavirus cases could reach several hundred thousand.

Many people in the US are under orders to refrain from venturing outside except for essential travel, but the federal government has yet to issue any national rules. President Trump has also discussed “reopening” the economy as soon as early April against the advice of numerous medical professionals and infectious disease experts. These manual ventilators might not be ideal, but they could still save a lot of lives."

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In addition, if proven the person has antibodies, the person can go about their business, get back to work, etc. The rest would still need to do social distancing until we have the vaccine…

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How a Failure to Test Blinded the U.S. to Covid-19

this is a very sobering, disturbing report on the failure, by multiple government agencies, to address the virus.

"America squandered its best chance of containing the virus because of faulty test kits, red tape and lapses in leadership, interviews show.

WASHINGTON — Early on, the dozen federal officials charged with defending America against the coronavirus gathered day after day in the White House Situation Room, consumed by crises. They grappled with how to evacuate the United States consulate in Wuhan, China, ban Chinese travelers and extract Americans from the Diamond Princess and other cruise ships.

The members of the coronavirus task force typically devoted only five or 10 minutes, often at the end of contentious meetings, to talk about testing, several participants recalled. The Centers for Disease Control and Prevention, its leaders assured the others, had developed a diagnostic model that would be rolled out quickly as a first step.

But as the deadly virus from China spread with ferocity across the United States between late January and early March, large-scale testing of people who might have been infected did not happen — because of technical flaws, regulatory hurdles, business-as-usual bureaucracies and lack of leadership at multiple levels, according to interviews with more than 50 current and former public health officials, administration officials, senior scientists and company executives.

The result was a lost month, when the world’s richest country — armed with some of the most highly trained scientists and infectious disease specialists — squandered its best chance of containing the virus’s spread. Instead, Americans were left largely blind to the scale of a looming public health catastrophe.

The absence of robust screening until it was “far too late” revealed failures across the government, said Dr. Thomas Frieden, the former C.D.C. director. Jennifer Nuzzo, an epidemiologist at Johns Hopkins, said the Trump administration had “incredibly limited” views of the pathogen’s potential impact. Dr. Margaret Hamburg, the former commissioner of the Food and Drug Administration, said the lapse enabled “exponential growth of cases.”

And Dr. Anthony S. Fauci, a top government scientist involved in the fight against the virus, told members of Congress that the early inability to test was “a failing” of the administration’s response to a deadly, global pandemic. “Why,” he asked later in a magazine interview, “were we not able to mobilize on a broader scale?”

Across the government, they said, three agencies responsible for detecting and combating threats like the coronavirus failed to prepare quickly enough. Even as scientists looked at China and sounded alarms, none of the agencies’ directors conveyed the urgency required to spur a no-holds-barred defense.

Dr. Robert R. Redfield, 68, a former military doctor and prominent AIDS researcher who directs the C.D.C., trusted his veteran scientists to create the world’s most precise test for the coronavirus and share it with state laboratories. When flaws in the test became apparent in February, he promised a quick fix, though it took weeks to settle on a solution.

At the start of that crucial lost month, when his government could have rallied, the president was distracted by impeachment and dismissive of the threat to the public’s health or the nation’s economy. By the end of the month, Mr. Trump claimed the virus was about to dissipate in the United States, saying: “It’s going to disappear. One day — it’s like a miracle — it will disappear.”

By early March, after federal officials finally announced changes to expand testing, it was too late. With the early lapses, containment was no longer an option. The tool kit of epidemiology would shift — lockdowns, social disruption, intensive medical treatment — in hopes of mitigating the harm.

Now, the United States has more than 100,000 coronavirus cases, the most of any country in the world. Deaths are rising, cities are shuttered, the economy is sputtering and everyday life is upended. And still, many Americans sickened by the virus cannot get tested."

https://www.nytimes.com/2020/03/28/us/testing-coronavirus-pandemic.html?action=click&module=Spotlight&pgtype=Homepage

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‘This is War’: President’s Equipment Czar to Use Full Powers to Fight Coronavirus
Peter Navarro says most companies ready to cooperate but president ready to knock down obstacles ‘unmercifully’

WASHINGTON—Peter Navarro, the Trump administration adviser chosen to oversee its wartime powers forcing private businesses into the fight against the coronavirus pandemic, said the full arsenal of federal measures are on the table, from raids on warehouses to compelling suppliers to retool factories.

“The vast majority of this nation’s unprecedented industrial mobilization will come patriotically, voluntarily, organically and innovatively,” said Mr. Navarro, who was appointed by President Trump on Friday to take on the presidential task-force role of coordinating government-business cooperation in an effort to tackle the pandemic.

But Mr. Navarro refused to rule out tougher measures. “This is war,” he said in an exclusive interview with The Wall Street Journal. “When there are bumps in the road, President Trump is going to knock them down immediately and unmercifully.”

Facing criticism it has moved too slowly to combat the epidemic, the Trump administration on Friday invoked for the first time the Defense Production Act, a law from the Korean War era giving it the power to force businesses to divert production capacity in the name of a national emergency.

The target was General Motors Co., which President Trump said was moving too slowly in converting auto-production capabilities to the ventilators needed to relieve an anticipated flood of patients struggling to breath after contracting Covid-19. GM said it already had been working “around the clock for weeks to meet this urgent need.”

Mr. Navarro also said that under the DPA, the Justice Department is considering raids on warehouses and action against suppliers who could be impeding the swift delivery of protective equipment to health workers and other professionals.

“The clear signal President Trump wants to send to anybody who thinks they can hoard or price gouge is that they must immediately move their inventory out of their warehouses and offer them at a fair price,” he said.

“To do anything less is to have blood on their hands,” Mr. Navarro said.

By choosing Mr. Navarro as his DPA policy coordinator, Mr. Trump has enlisted a brusque loyalist and one of the more polarizing figures in the administration. Navarro, 70 years old, is the director of the thinly staffed Office of Trade and Manufacturing Policy, and his role has grown more expansive as the president’s team has continued to churn.

Mr. Navarro for weeks has been working on supply-chain issues related to the crisis and has coordinated directly with companies to marshal equipment, including FedEx Corp. Chief Executive Fred Smith to distribute hundreds of thousands of specialized testing swabs flown in from Italy and smoothing a contract with Honeywell International Inc. to produce N95 respirators.

A California economics professor and one-time Democratic candidate for Congress, Mr. Navarro arrived on Mr. Trump’s radar during the 2016 campaign because of his books on China as a growing threat to U.S. dominance.

The president has often leaned on Mr. Navarro during internal policy debates over trade, calling out, “Where’s my Peter?” when feeling outnumbered by those who have objected to protectionist measures.

Mr. Navarro’s writings have touched on pandemics in the past. “China has become the world’s prime breeding ground for new and exotic strains of influenza and other viruses,” he wrote in the 2006 book, “The Coming China Wars.”

“As soon as I saw a novel coronavirus emerge in Wuhan, my radar went up,” Mr. Navarro said on Saturday. He accused Chinese officials who visited the White House in mid-January for the signing of the phase one trade deal of suppressing crucial information—even possibly transmitting the disease.

“They shook our hands. We broke bread with them,” he said. “They smiled and left with nary a warning about the severity of the crisis.”

The Chinese Embassy in Washington in a statement Saturday pointed to comments made earlier this month by Foreign Ministry spokesman Geng Shuang, who provided a timeline of contacts between officials in both countries, starting with a conversation on Jan. 3. He also noted Mr. Trump’s praise of China’s response on Twitter.

“We hope the U.S. side will respect facts and the international consensus and keep its own house in order rather than slander others and shift responsibility,” Mr. Geng said.

During a press briefing Friday in which Mr. Trump named him as the DPA coordinator, Mr. Navarro cast it in historical terms. “We are engaged in the most significant industrial mobilization since World War II,” he said.

“Over the last several days, we ran into roadblocks with GM,” Mr. Navarro added. “We cannot afford to lose a single day, particularly over the next 30 to 60 days. So President Trump invoked the Defense Production Act as a way of enhancing and accelerating this mobilization. I salute him for doing so. It’s going to make my job so much easier.”

Mr. Trump, meantime, has drawn criticism for an uneven approach to the issue. Despite invoking DPA on March 18, the president was reluctant to use it, facing pushback from business groups and some of his own advisers, who have raised concerns about the effect such a move could have on the economy.

Mr. Navarro is now overseeing potential further use of the emergency powers, though he, too, prefers the less hostile approach. In the interview Saturday, he said he is in talks, along with the Federal Emergency Management Agency and the Department of Health and Human Services, with about a dozen ventilator companies and that progress was being made.

“It’s a mission, not a job,” Mr. Navarro said of his role. Underneath a clock in his office is a sign that reads Trump Time. Mr. Navarro translated that to mean getting things done “as soon as humanly possible. Most times that means leveraging the full power of the federal government. Sometimes it means smashing through the bureaucratic red tape.”

https://www.wsj.com/articles/this-is-war-presidents-equipment-czar-to-use-full-powers-to-fight-coronavirus-11585435836?mod=hp_lead_pos4

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“ If you’re living with your SO and you’ve both been quarantined for 2 weeks, what is the risk? (Both, admittedly, are not givens but applies to most couples giving birth right now.) And if you ARE worried, they should wear masks the whole time but still allowed to be there.”

Instead of one person, there are now two possible sources of contagion in the hospital. Yes, the risk goes up. The restrictions make perfect sense.

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But not having a trusted person around who can calm you down/assert your interests/monitor your situation does increase the risk for mother and baby as well. It’s not simply about comfort. I have had one birth where I would have been fine without my husband, but two medically complicated births where he was sorely needed.

I think it should be a political decision to restrict attendance to no more than one person, but beyond that, a medical risk assessment by the attending OB, whether they feel safe with that particular person in the delivery room, and what restrictions to place on them.

Ideally, mother and attendant should be tested in arrival.

@romanigypsyeyes , please know our thoughts are with you. Be safe.

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Not to mention if stars forbid something happens to the birth parent and you now have no one to advocate for the baby.

I can write out in detail what I want to happen to me but if something happens, what legal next of kin would make immediate decisions?

Even the most draconian policies I’ve seen haven’t left minors alone assuming no one is showing signs of infectious illness.

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Doctors should decide this. Not politicians.

Exactly. Most seem to believe the federal government should defer to the doctors and scientist. The state governments should therefore do the same. Cuomo is a doctor now?

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Links regarding making homemade masks and their potential effectiveness. Every little bit helps.

DIY surgical mask:

https://sarahmaker.com/wp-json/mv-create/v1/creations/12/print

Link regarding effectiveness of different materials:

https://smartairfilters.com/en/blog/best-materials-make-diy-face-mask-virus/

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Some guidelines must be put in place by authorities, that means it’s a political decision in the first place. There will be pressure fro all sides, on doctors and on the pregnant woman - some families may try to put pressure on for more access, others for less access, some hospitals may want to do one thing, others another - as long as there aren’t enough tests, it’s not a clear cut yes/no for anything, it’s risk management. Weighing pros/cons. A number of sensible posters have already come up with different answers on what’s right.

In these murky waters, politicians and/or authorities make choices for all of us, and take responsibility for it.

Slightly related situation: when my newborn child was in the PICU, I was very glad that no one other that than the parents were allowed in. As soon as the baby was moved to the lower level NICU, there was immediate in law pressure for visits, and my husband caved, which was a huge extra level of stress for me, who was already on a super exhausting 24 h schedule of pumping, breastfeeding, caring (two more little ones at home, too).

It’s the difference between imploring people, employers, parents to be reasonable and ordering and enforcing lockdowns. Sometimes it’s the politicians job to make decisions easier for people.

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I just saw that the CDC estimated that 80,000 Americans died from the flu in winter 2017-18, on average 500 a day during the flu season, with more than 900,000 hospitalizations.

https://www.cdc.gov/flu/spotlights/press-conference-2018-19.htm

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@romanigypsyeyes wishing you and Mr. R all the best!

Regarding restrictions in Labor and
Delivery and Postpartum wards, my husband is an Ob/gyn. The. restrictions in place in his department came with a great deal of discussion. They were not slapped on quickly or easily. That said, they are pretty reasonable. A laboring woman may check in with a maximum of two helpers. Once in L and D those two may not leave. They may switch with each other in the patient’s room for breaks but they are not allowed To leave the ward. Two are allowed to allow for those patients who have a private doula, which the department agreed they consider to be “medical” personnel and who provide help. Once the patient delivers, only one of those two may accompany the mother and baby to the postpartum ward, and again, that person may not leave the hospital until mother and baby are discharged.

My husband’s department has had three covid scares and they have now divided their staff into three teams that do not physically come in contact. The rotate weekly, from patient contact (L and D, clinic visits, surgery) to a week of telemedicine, to a week off and repeat. The residents and nurses have their own similar schedules. This way they hope to create a firewall of well providers.

The covid scares included a resident who developed symptoms while at work. Ge was sent for testing and sent home immediately. He tested positive.

Another scare involved a pregnant patient near term who presented at the ER feeling ill but not with typical covid symptoms. The hospital had just set up their covid testing tent outside, and this process was a bit chaotic. The patient was sent from the ER to L and D, where she vomited. A test revealed she was positive.

Both of those scares resulted in every provider, nurse and tech who had come into contact with the positive person immediately sent for testing and sent home pending results. The department at one point was down nearly 20 physicians nurses and techs.

It is extremely important to take this seriously. While we’d all hate to deliver alone, we’d all like to have a fully staffed labor delivery and post partum area in which to welcome our baby!

Aside: American troops in Italy have American staffed clinics on their bases but no base hospitals. Those troops and families use local civilian hospitals for that level of care, including giving birth. For several months now the local Italian rules have not allowed anyone but the mother to enter the hospital. She is dropped off at the doors, and mother and baby are picked up at the doors upon discharge.

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@OneMoreToGo2021. I am really hoping that when this is all over (don’t think it will be truly over just another vaccine for it in the short term but think years) there will be more stress about preventing the general flu and not just get a flu shot. More emphasis about cleaning surfaces and washing hands /not touching our face etc
Maybe we can somehow limit those deaths in the future.

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While Cuomo is yapping “not enough” after getting 2,000 ventilators from the FED, CA is fixing and making it work after LA got only 170 ventilators from the FED, without much ado. This is how we are all in this together, not yapping nonstop.

https://www.msn.com/en-us/news/us/coronavirus-cases-in-california-icus-double-overnight-as-manufacturers-race-to-fill-shortages/ar-BB11QLdn?li=BBnb7Kz&ocid=mailsignout

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Added to my above post 11158, this is an ever evolving situation, and restrictions may become more tight if needed.

Every provider (maybe every employee? I don’t know.) is required to take their own temperature twice a day and to stay home if they develop any fever or other symptoms. The health of the providers - so that they can continue to provide high level care to every mother and baby is important.

My husband’s department lost a couple of people this week who have been tasked to staff one of the hospital ships. They can’t afford to lose more.

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We can learn quite a bit in terms of what Taiwan did to contain the virus, https://www.nbcnews.com/health/health-news/what-taiwan-can-teach-world-fighting-coronavirus-n1153826.

  1. They sent a medical team to Wuhan as soon as they heard about the virus and was the first country to stop flights from Wuhan and then China (Jan), before a first case was detected.
  2. The stopped exporting PPEs to other countries and capped the price of masks to anyone (no price bidding).
  3. They set up a command center:
  1. Used technology to detect and tract the virus. They used big data to combine immigration data, insurance, temperature, GPS to figure out who is at risk, who should be quarantined, and to see how the virus was spreading.
  2. They made supplies available and educated public of the virus very early on. The government got the buy in from the public. 95% of parents were reporting their kids’ temperature to school everyday.
  3. They tested people and retested them on regular basis (based on risk).
    The list goes on. Taiwan didn’t have to shut down their economy or close down their schools. They learned from SARs. I am just wondering why other countries, especially US, couldn’t have done the same. Why are we scrambling now. I really hope one good thing coming out of this pandemic is we will be more prepared next time, and there will be a next time.
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Cuomo is listening to the doctors and coordinating response based on their input. He isn’t going by his hunches and gut instincts.

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One of my children was born after ~27 hours of literally gut wrenching back labor. For most of that time the medical team was nowhere in sight.

It wasn’t the medical team who held the pan I vomited in repeatedly or who held the cup and coaxed me to drink water in between episodes so I stayed hydrated. Or who coaxed me to have a few bites of food to keep up my strength.

They weren’t the ones who physically supported me so I didn’t fall on the way to the bathroom or who walked around with me for hours trying to get the baby to move as he ratched down every disc in my spine and ground his bony little head against them one by one.

When the baby’s heart rate started to drop, it was the calm insistence of my husband that gave me the strength I needed to give the final push to deliver our baby. I endured postpartum depression for months and I think it was directly related to how physically exhausting the labor was.

My mother wasn’t as fortunate. In that era, women were left alone to labor with their feet in stirrups. My brother didn’t survive the birth. The situation she described was horrible.

Most of you aren’t doctors either, and I doubt you have a team of medical experts at your disposal to advise you on policy. Governor Cuomo has a responsibility to all the citizens of our state. He made the right decision.